Circadian rhythm sleep disorder increases risk of open-angle glaucoma, but melatonin use may reduce this risk
In a retrospective cohort study of 24,730 matched pairs, patients with circadian rhythm sleep disorder (CRSD) had a significantly higher risk of open-angle glaucoma (OAG) at 1 year (0.14% vs. 0.04%; aHR 2.67), 3 years (0.25% vs. 0.07%; aHR 3.02), and 5 years (0.27% vs. 0.08%; aHR 2.88). Among CRSD patients using melatonin, the risk of OAG was not significantly different from controls, suggesting a potential protective effect of melatonin.
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Circadian rhythm sleep disorder increases risk of open-angle glaucoma, but melatonin use may reduce this risk The current body of evidence comprises 1 study. EvidenceHub rates the overall confidence at 34/100 (low).
The Claim
Circadian rhythm sleep disorder increases risk of open-angle glaucoma, but melatonin use may reduce this risk
This conclusion is most relevant to: Adults (≥18 years) with CRSD matched 1:1 to polysomnography-tested controls without sleep disorders from TriNetX database.
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Association between circadian rhythm sleep disorder and open-angle glaucoma: The modifying role of melatonin. (Research square, 2026) —
How It Works
The proposed biological pathway:
- ▸CRSD disrupts neurovascular regulation
- ▸Disrupted neurovascular regulation increases intraocular pressure or optic nerve vulnerability
- ▸Melatonin may restore circadian rhythms or provide direct neuroprotective effects
- ▸Result: Reduced risk of OAG in melatonin users
Who Might Benefit
Evidence fit by population:
- ▸Adults (≥18 years) with CRSD matched 1:1 to polysomnography-tested controls without sleep disorders from TriNetX database
Recommended Dose
N/A
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Retrospective cohort design limits causal inference
- ▸Reliance on ICD-10 codes may introduce misclassification bias
- ▸Melatonin use was based on prescription records, not actual adherence or dosage
Frequently Asked Questions
What is the main finding of this study?▼
Circadian rhythm sleep disorder is associated with a nearly threefold increased risk of open-angle glaucoma over 5 years, but this risk appears to be mitigated in patients using melatonin.
How large was the study population?▼
The study included 24,730 matched pairs (49,460 total patients) from the TriNetX database.
Did melatonin completely eliminate the risk of glaucoma?▼
No, but the risk was no longer statistically significant in melatonin users (5-year OAG: 0.52% vs. 0.32%; aHR 2.07, 95% CI 0.88-4.84, P=.23).
What type of study was this?▼
This was a retrospective cohort study using electronic health record data from TriNetX.
References
- 1.Eleiwa T, Chauhan M, Kishor K, Al Aref S, Khodeiry M, Abboud I, Bhattacharya S, Lee R, Elhusseiny A. “Association between circadian rhythm sleep disorder and open-angle glaucoma: The modifying role of melatonin..” Research square, 2026. PMID: 42396504 DOI: 10.21203/rs.3.rs-9740601/v1